In many ways, 2020 has been a remarkable year, but its impact on our mental health has been palpable. Social isolation, sadness, loss of money, working from home, and disruptions in education, among other things, have started or aggravated mental health disorders.
Depression and anxiety rates have risen to nearly 30% in the United States alone, according to studies. Covid-19, on the other hand, has been linked to a number of neurologic and mental health issues, including anxiety, sleeplessness, and depression. There is also fresh evidence that persons with substance use problems and psychiatric disorders are more likely to have worsening disease outcomes.
Despite all of these complicating factors, new research by the World Health Organization (WHO) found that the epidemic has suspended or affected mental health services in 93 percent of countries throughout the world.
And, despite the fact that mental health appears to be a priority and is featured in 89 percent of the nations surveyed’s national Covid-19 response plans, just 17 percent of these countries have provided additional resources for it. In other words, despite the increased demand for mental health care, financing remains insufficient. In fact, mental health receives less than 1% of all international aid dedicated to health.
It’s difficult to know anything about mental health when there are so many hurdles to care and so little financial commitment by governments. These are the eight facts mental health specialists want you to know right now, in honor of World Mental Health Day.
1. It Is Normal To Feel Bad Right Now
While there is no one-size-fits-all solution to a worldwide pandemic, feeling overwhelmed right now is not only normal but expected. Many people’s perception of stability has shifted, according to Dr. Samantha Meltzer-Brody, Assad Meymandi Distinguished Professor and Chair, Department of Psychiatry, the University of North Carolina at Chapel Hill. As a result, individuals can “feel like they’re walking on shifting sands and be profoundly agitated, worried, or depressed,” according to her.
Dr. John M. Constantino, Professor of Psychiatry and Pediatrics at Washington University in St. Louis and Psychiatrist-In-Chief at St. Louis Children’s Hospital, noted that uncertainty about the future and a person’s inability to shape it can cause symptoms like depression, helplessness, hopelessness, and meaninglessness to occur more frequently and intensely than usual.
“If you feel bad, you’re paying attention,” said Dr. Kaz J. Nelson, Associate Professor and Vice-Chair for Education in the Department of Psychiatry & Behavioral Sciences at the University of Minnesota Medical School.
Our bodies and brains are programmed to respond to threats, and when they are engaged, our brain’s ability to concentrate, plan, compute or even feel compassion for others is reduced. When these risks persist for an extended period of time, our bodies shut down to conserve energy, resulting in depletion or fatigue. “If you’re feeling this way, it implies your body is doing what it’s been wired to do to survive,” she continued. It doesn’t imply that you’re ‘broken’ or ‘badly wired.’”
Uncertainty about the future and a person’s inability to shape it, according to Dr. John M. Constantino, Professor of Psychiatry and Pediatrics at Washington University in St. Louis and Psychiatrist-In-Chief at St. Louis Children’s Hospital, can cause symptoms like depression, helplessness, hopelessness, and meaninglessness to occur more frequently and intensely than usual.
Dr. Kaz J. Nelson, Associate Professor and Vice-Chair for Education in the Department of Psychiatry & Behavioral Sciences at the University of Minnesota Medical School, remarked, “If you feel bad, you’re paying attention.”
2. It’s OK Not To Be OK
Having strong mental health, according to Dr. Jennifer M. Gómez, Assistant Professor in the Department of Psychology and the Merrill Palmer Skillman Institute for Child and Family Development (MPSI) at Wayne State University, does not imply that you are always happy.
She stated that a wide range of emotions, including sadness, rage, and grief, are “integral components of being alive.” Dr. Gómez listed a number of environmental triggers, including Covid-19 and police aggression, and emphasized that reacting positively after experiencing any of them directly or indirectly would be unusual. “If you’re struggling, there’s nothing fundamentally wrong with you,” she continued.
“I want you to truly hear it when people say “it’s acceptable not to be okay,” said Dr. Riana Elyse Anderson, Assistant Professor at the University of Michigan. She stated that navigating this high level of stress from multiple sources at the same time has never been done before, and our bodies were not designed to do it.
“Would you know how to get from point A to point B if you didn’t have your GPS?” she asked. Dr. Kevin M. Simon, a fellow in child and adolescent psychiatry and addiction medicine at Boston Children’s Hospital/Harvard Medical School, noted that being proactive about seeking salves is an important part of dealing with stress and staying mentally well.
3. Prioritize Self Care, Find What Works
It’s important to focus on yourself whenever you can, even if it’s difficult with so many conflicting requirements. “If the epidemic has taught us anything, it’s that mental health is not “extra,” said Dr. Pooja Lakshmin, Clinical Assistant Professor in the Department of Psychiatry & Behavioral Sciences at George Washington University School of Medicine.
“Mental health is the same as physical health.” She went on to say that women, in particular, frequently mistakenly believe that self-care is selfish, which is not the case. “Your mental health is the foundation upon which the entire house is built,” Dr. Lakshmin believes. Never feel bad about devoting time and attention to yourself.”
Self-care, on the other hand, can look very different right now than it usually does. According to Joey Lusvardi, a mental physician assistant, you may not be able to do all of the things you generally enjoy doing on Covid-19, or you may not find them as soothing due to precautions.
However, finding ways to relax is still crucial. He suggested that you use this time to discover new hobbies or interests, and that self-care can also involve less “sexy” activities such as sticking to a routine, keeping your house tidy, and showering.
Dr. Meltzer-Brody recommended that we “prioritize doing activities that give us a sense of stability or grounding—in whatever tiny ways we can” to maintain our mental health. This can be accomplished by focusing on activities that seem soothing or restorative to us, such as interacting with friends and family or getting outside and enjoying nature, according to her.
Dr. Jack Turban, a Stanford University School of Medicine Fellow in Child and Adolescent Psychiatry, explained that “social distancing” with Covid-19 resulted in social withdrawal, which exacerbated depression. Instead, he likes the phrase “physical separation” and frequently encourages patients to maintain social connections only in safe ways (for example, by texting).
4. Boundaries Are Not Just Acceptable, They Are Necessary
According to Dr. Meltzer Brody, protecting our mental health and focusing on self-care should also include becoming aware of the triggers that make us feel worse (such as social media or the news) and finding strategies to minimize or replace them with activities that are more nutritious or calming.
Saying no to requests we don’t want to do right away, even though it’s difficult, and taking breaks and time off when we can are examples of this. “If you have left at work, take it,” said Dr. Nicole Washington, Chief Medical Officer at Elocin Psychiatric Services. Take a vacation from the news and social media if you need it. These pauses are necessary for recharging and promoting mental health.”
Boundaries between work and home are also important for our mental health, especially today that so many people work from home. Due to the blurred lines between the two worlds and work late into the evenings, many of Dr. Washington’s patients now live at work. She stated that this is not a long-term solution and will result in burnout.
She suggests working in a setting that isn’t your home and avoiding it during non-work hours to help. If it isn’t an option, she suggests “boxing up” your “office” at the end of the day so that “returning to it isn’t easy.” “Some days I really step outside for a few minutes at the end of my workday practically as a symbol of leaving work,” she continued.
5. Be Nicer To Yourself…And Others
Many of the professionals interviewed said it’s critical right now to accept that you won’t be as prolific as you once were, and that’s fine. “Your best is not attainable under these circumstances,” Jessica Dyer, LCSW, Director of WashU Cares at Washington University in St. Louis, explained.
Right now, it’s about learning to ride the ups and downs of life while remaining compassionate to ourselves throughout a high-stress period.” Dr. Washington went on to say that because expecting the same level of productivity can generate emotional pain or self-doubt, it’s a good idea to change your goals to something more realistic and “in sync with the reality we’re trying to function in right now.”
Then, when you achieve anything, you may rejoice, which is something we all need right now.
Dr. Sherrita A. Strong, Director of Inclusion and Assistant Professor in the Department of Psychiatry at UNMC, has discovered that, given our current limitations, we also require more self-compassion and compassion for our coworkers, friends, and family. “As we grow more stressed, we have a tendency to have less empathy for ourselves and others,” she stated. Remember to provide grace to one another and to ourselves, and to remember that we are all doing our best.”
6. You Are Not Alone, Reach Out To Others
Sharing your fears, sadness, or anxiety with others might be beneficial. Dr. Chase T.M. Anderson, a UCSF Fellow in Child and Adolescent Psychiatry, stressed the importance of people, particularly minoritized people, understanding that they are not alone and that reaching out can help. “You are seen,” he stated he’d like to tell them. You are cherished. You are important… “Hold your head up high.”
Yet, due to the stigma and guilt associated with seeking help, many people are hesitant to do so. There is no shame in battling with your mental health, according to Abhishek Chandan Khandai, Assistant Professor of Psychiatry at the University of Illinois-Chicago, but there is shame in criticizing others who do.
Dr. Anne Glowinski, Professor of Psychiatry at Washington University in St. Louis and Associate Chief of the Division of Child and Adolescent Psychiatry, believes that asking for help is a strength. She sincerely hopes that people would open up to one another and receive the help they require.
Because stigma might prevent people from seeking treatment, it is critical that you, as a friend or family member, reach out to someone you suspect is struggling rather than waiting for them to reach out to you. “When someone is drowning, you don’t ask them to swim to you; you toss them a life preserver,” Dr. Khandai added.
Dr. Turban noted that being at home has exacerbated the mental health of LGBTQ teenagers, a demographic on which his study focuses, and that they could benefit from a phone call for help as a check-in. “Even a single affirming accepting voice can have a good impact on [they’re] mental health,” he said.
7. Get Professional Help If You Need It
People frequently put off seeking professional care until they are in a crisis, citing stigma, a lack of time, or the belief that their symptoms will go away as reasons. However, Dr. Lisa Merlo, a licensed psychologist and Director of Wellness Programs at the University of Florida College of Medicine, believes that reaching out early is vital because treatment is frequently faster, more successful, and less expensive. It also stops you from suffering unnecessarily as a result of your condition. “The point at which you FIRST think, ‘I wonder if I should get some help,’ is the optimum time to reach out,” she noted.
Dr. Christine Moutier, Chief Medical Officer of the American Foundation for Suicide Prevention, expressed a similar opinion, saying that we should not wait until we are in crisis to “get serious about mental health.”
Myriad people are unaware of the many ways mental health affects their life, including their relationships, work productivity, and physical health, including sleep, energy, sexual functioning, and even pain/inflammatory disorders, according to her. “Because mental health influences more than just our thoughts, feelings, and mood,” she continued, “if we start finding methods to make mental health a priority, we can actually have far greater influence over our lives.”
Dr. Carol Bernstein, Professor and Vice-Chair for Faculty Development and Wellbeing at Montefiore Medical Center/Albert Einstein College of Medicine, agreed that mental health should not be treated as the “neglected stepchild of healthcare,” and that people should always “make sure to take care of their emotional needs as well as their physical needs.”
This does not mean, however, that you know how to seek aid, which the experts identified as a difficult aspect of requesting help. Depending on the severity of your symptoms, Dr. John Krystal, McNeil Professor and Chair of Psychiatry at Yale School of Medicine, said there are several levels of care and ways to obtain help.
He emphasized that feeling “off” or not getting along with your family or coworkers could be signs of stress and that you should seek help. There are a variety of techniques to de-stress, including sleep, exercise, meditation, and counseling, according to Dr. Krystal, and it’s crucial to figure out which method works best for you. If you experience more significant symptoms, such as a lack of enjoyment in life or a sense of hopelessness, you may be depressed, and medication, coupled with exercise and counseling, may be helpful, according to Dr. Krystal. In the end, treatments work, and as Dr. Merlo puts it, “you won’t know how much better you may feel until you try.”
8. Mental Health Is Health
Finally, many of those interviewed stressed the need of recognising and prioritizing mental health in order to transform the system and lower obstacles to care. “A system that ignores or discriminates against mental healthcare is a system that rejects who we are as human beings,” said Dr. Rona Hu, Clinical Professor of Psychiatry and Associate Dean of Academic Affairs at Stanford University School of Medicine. There is no such thing as physical wellness without mental health.”
Dr. Gail Saltz, Clinical Associate Professor of Psychiatry at Weill Cornell School of Medicine at The New York-Presbyterian Hospital, noted that stigma and lack of access keep many people with mental illnesses from seeking the help they need. As a result, she stated that “attention and access to mental health care in this society requires more prioritization.”
According to Dr. Joan Cook, Clinical psychologist and Associate Professor at Yale School of Medicine, it is critical to work to make physical and mental health equal and to recognize that there are still discrepancies in who has access to effective mental health care.
Advocating for mental health and substance use to be covered by insurance in the same way that physical health is will help to make effective services available to everyone.
“This is a lofty and urgent, but feasible order,” Dr. Cook said. While 2020 has been a unique and difficult year, one thing that has not altered is the importance of mental health access and delivery, particularly for our most vulnerable populations, according to Dr. Michael McClurkin, a psychiatry resident at Yale School of Medicine. “As millions of people’s healthcare are in jeopardy due to a rising COVID-19 public health crisis, we must continue to raise the alarm for increased funding,” he said.
Finally, on this World Mental Health Day, pay attention to the experts and consider making mental health a priority, at least for yourself.